Exophthalmos (ʻōhū nā maka)

Exophthalmos (ʻōhū nā maka)

Pehea i wehewehe ʻia ai ka exophthalmos?

ʻO Exophthalmos ka huaʻōlelo i hoʻohana ʻia e kuhikuhi i ka puka ʻana o hoʻokahi a i ʻole nā ​​​​maka ʻelua ma waho o ka orbit. Ke kamaʻilio nei mākou no nā maka a i ʻole nā ​​maka bulging (s).

ʻOi aku ka nui o ka maka, ʻoi aku ka "wehe", hiki ke hoʻopilikia i ka pani ʻana o ka lihilihi me ka hoʻopilikia ʻana i ka nani. ʻAʻole ʻo Exophthalmos ma muli o ka hoʻonui ʻana i ka nui o ka maka, akā no ka hoʻonui ʻana i ka nui o nā ʻiʻo a i ʻole nā ​​hale i loko o ka maka (hiki i kahi puʻupuʻu i ka maka). orbit). Hiki ke ʻoki ʻia ka maka ʻōpuʻu a ʻike ʻia he ʻano ʻē aʻe ka nānā ʻana mai ka maka maʻamau. I ka hapanui o nā hihia, pili nā maka ʻelua.

Hiki ke hoʻokaʻawale ʻia a pili paha ʻo Exophthalmos me nā hōʻailona ʻē aʻe, e like me ka emi ʻana o ka ʻike maka, ʻike pālua (diplopia), ʻeha, ʻulaʻula, etc.

Hiki i ka Exophthalmos ke akaka a hōʻino ʻia, akā ʻaʻole i ʻike koke ʻia: hiki ke ʻike ʻia i ka wā o ka nānā maka maʻamau.

He aha nā kumu o ka exophthalmos?

Nui nā kumu o ka exophthalmos: endocrine, tumor, inflammatory, traumatic a me ka vascular.

E nānā ke kauka ophthalmologist i ke ʻano unilateral a i ʻole bilateral o ka maʻi, kona ala (wikiwiki a ʻaʻole ʻole), inā ʻaʻa ʻole ka maka a i ʻole ("axillary" a i ʻole ke ʻano axillary), a me ka manaʻo o ka "pulse" a i ʻole ka pulsation. i loko o ka maka (ʻano puʻupuʻu).

Ma keʻano laulā, ua like ka hoʻomaka koke o ka exophthalmos i kahi trauma a i ʻole kahi maʻi ʻeha. Ke hoʻomaka lohi nei, ʻoi aku ka maʻi o ka endocrine a i ʻole ka pathology tumor.

Eia nā kumu maʻamau:

  • ʻO ka maʻi ʻo Graves: he maʻi kēia o ka thyroid gland (hyperthyroidism) ma ke ʻano he autoimmune kumu. ʻO ia ka mea e hoʻomāmā ai i nā ʻiʻo o ka pōpō maka, ka mea e pehu ai a puka ka maka. Hiki ke hoʻopili ʻia nā maʻi thyroid ʻē aʻe (ke kamaʻilio nei mākou no ka dysthyroid orbitopathy ma ka laulā: hyperthyroidism ma 80% o nā hihia, hypothyroidism ma kahi o 10%). ʻO ka pinepine, ʻo ka exophthalmos ka bilateral.
  • carotid-cavernous fistula: ʻo ia ke kumu i ʻike pinepine ʻia inā he unilateral a me ka pulsatile ka exophthalmos. He kamaʻilio maʻamau ia ma waena o ka carotid kūloko a me ka cavernous sinus (ka hoʻokumu ʻana o ka venous ma ke kumu o ka ʻiʻo), pinepine ma muli o ka ʻeha. He pilikia olakino ia, he mea weliweli i ke ola.
  • Traumatic exophthalmos: hiki mai lākou ma hope o kahi haʻalulu (hematoma, haʻihaʻi o ka orbit, a me nā mea ʻē aʻe) a i ʻole kahi ʻeha poʻo.
  • Infectious exophthalmos: ʻo ia ka hopena o ka ethmoiditis, ʻo ia hoʻi ka maʻi o ka ethmoid, he iwi ma waena o nā kumu ʻelua. Hoʻopilikia nui ia i nā keiki a me nā ʻōpio.
  • ʻO nā exophthalmos inflammatory:ʻaʻole iʻike mauʻia ko lākou kumu, akā hiki ke pili i kekahi mau maʻi pūnaewele e like me sarcoidosis, periarteritis nodosa, Wegener's maʻi, inflammatory vasculitis, a pēlā aku. .
  • ʻO Tumor exophthalmos: ma muli o ka loaʻa ʻana o ka nui o ka maʻi maʻi i loko o ka pōpō maka. Hiki i nā ʻano ʻokoʻa he nui ke hoʻopilikia i kēia wahi. Hiki iā ia ke metastases mai kahi pūnaewele ʻē aʻe.

He aha nā hopena o ka exophthalmos?

Ma waho aʻe o ka hiʻohiʻona maikaʻi ʻole o ka exophthalmos, hiki iā ia ke hoʻopilikia i ka ʻike, e hui pū ʻia me ka ʻeha, nā pilikia e hoʻopilikia ai i ka ʻike… No laila pono e nīnau koke i kāu kauka ophthalmologist.

He mau mea hana kēia e nānā i ke koʻikoʻi o ka exophthalmos. ʻO ka pinepine, e kuhikuhi ʻo ia i nā hoʻokolohua kiʻi (CT scan, MRI) e hoʻokumu i ka maʻi.

He aha nā hoʻonā i ka hihia o exophthalmos?

ʻO ka mālama ʻana no ka exophthalmos ma muli o ke kumu. He lāʻau lapaʻau a ʻokiʻoki paha.

I ka hopena o ka maʻi thyroid, ʻo ia ke kumu maʻamau, ʻo ka lawe ʻana i ka lāʻau antithyroid i nā mahina he nui e kōkua pinepine i ka hoʻihoʻi ʻana i nā pae hormone thyroid maʻamau. ʻO ka wehe ʻana i ka thyroid a me ka lawe ʻana i ka iodine radioactive hiki ke manaʻo ʻia, ma muli o ka hihia.

ʻAʻole hoʻomaikaʻi mau ʻo Exophthalmos me ka mālama ʻana: i kekahi manawa ua hoʻonui ʻia e ia. Hiki ke kōkua i ka lawe ʻana i nā corticosteroids, a i kekahi manawa hiki ke hōʻike ʻia ke ʻoki ʻana, ma hope o ka hoʻihoʻi ʻia ʻana o ke kiʻekiʻe o ka hormone.

I nā hihia ʻē aʻe o exophthalmos, ma muli o ke kumu, hiki ke noʻonoʻo ʻia kekahi mau hopena. ʻO nā hopena ma muli o ke kūlana a me ka maʻi lalo.

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